US20240197367A1 - Bone screw and sleeve remover - Google Patents

Bone screw and sleeve remover Download PDF

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Publication number
US20240197367A1
US20240197367A1 US18/286,604 US202118286604A US2024197367A1 US 20240197367 A1 US20240197367 A1 US 20240197367A1 US 202118286604 A US202118286604 A US 202118286604A US 2024197367 A1 US2024197367 A1 US 2024197367A1
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US
United States
Prior art keywords
sleeve
tissue
bone screw
protecting sleeve
legs
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
US18/286,604
Other languages
English (en)
Inventor
Stefan Midderhoff
Michael Fromm
Frauke ZIMMERMANN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ulrich GmbH and Co KG
Original Assignee
Ulrich GmbH and Co KG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ulrich GmbH and Co KG filed Critical Ulrich GmbH and Co KG
Assigned to ULRICH GMBH & CO. KG reassignment ULRICH GMBH & CO. KG ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: Midderhoff, Stefan, ZIMMERMANN, Frauke, FROMM, MICHAEL
Publication of US20240197367A1 publication Critical patent/US20240197367A1/en
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/702—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other having a core or insert, and a sleeve, whereby a screw or hook can move along the core or in the sleeve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8863—Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Definitions

  • the invention relates to a bone screw having a screw shank that has a thread, and a screw head that has two legs that lie opposite one another and form a receptacle between them, which legs are connected, in one piece, with a tissue-protecting sleeve, wherein the tissue-protecting sleeve has a slot that runs from the one edge of the sleeve to the opposite edge.
  • the invention furthermore relates to a sleeve remover.
  • Bone screws are widespread in medicine for surgical applications, and are used in the embodiment of pedicle screws for correction and stabilization of the spinal column.
  • the screw shank configured as a threaded shank, is supplemented by a screw head structured as a tulip head, having a receptacle formed between the legs, in which receptacle a rod can be placed and fixed in place from the cranial to the caudal direction, which rod connects adjacent vertebrae or entire groups of vertebrae with one another.
  • pedicle screws are known, for example, from EP 2 452 642 A2.
  • the placement of the bone screw with the rod can take place in a conventional manner, over an operation field that has been exposed over a large area, wherein, however, the musculature must be released from the spinous processes of the vertebrae and moved aside so as to expose the pedicles.
  • a minimally invasive access is more advantageous, in which a small skin incision is made above the location where the bone screw is to be placed.
  • dilatation sleeves an operation channel for setting the bone screw or pedicle screw is created.
  • tissue-protecting sleeve is required, which is coupled with the bone screw and must be removed again after setting and fixation of the rod.
  • the bone screw mentioned initially is characterized in that the tissue-protecting sleeve is firmly connected with the screw head, namely both legs, in other words no measures are required for releasably coupling the tissue-protecting sleeve with the bone screw before the operation, and releasing this coupling again intra-operatively.
  • the bone screw together with the tissue-protecting sleeve can be handled as one piece, so that the tissue-protecting sleeve constantly and reliably performs its protective function for the operation channel.
  • tissue-protecting sleeve must be separated from the bone screw again after it has performed its function, and for this purpose the tissue-protecting sleeve has a particularly suitable configuration, having a slot that extends over its entire length expanse, which slot creates an access that can be used for the separation.
  • the legs of the screw head are connected with the tissue-protecting sleeve by way of a planned breaking point.
  • This planned breaking point can be acted on for separation, proceeding from the slot.
  • the tissue-protecting sleeve Due to the slot, the tissue-protecting sleeve is not closed in the circumference direction, and as a result its stability is restricted. In order to balance this out or to at least partially compensate for it, it is provided that the tissue-protecting sleeve has a stabilization bracket on the edge that lies opposite the legs.
  • the tissue-protecting sleeve has an opening on the side that lies opposite the slot, which opening extends from the edge facing the leg over part of the longitudinal expanse of the tissue-protecting sleeve, through which opening the rod can be introduced into the receptacle and laid in place, even when the tissue-protecting sleeve is still connected with the screw head.
  • the tissue-protecting sleeve is circular in cross-section and the slot extends over an arc having a length between 15° and 90°, in other words the arc covers an angle region that corresponds to a minimum of 15°.
  • the usable interval for the size of the arc ranges up to 90°, in other words a quarter circle, so that sufficient material remains for the purpose of the tissue-protecting sleeve.
  • a sleeve remover that can be placed over the tissue-protecting sleeve is provided for interaction with the bone screw, which sleeve remover has a separation element on its end facing the legs, in the configuration when it is set onto the tissue-protecting sleeve, on its inside circumference, and the expanse of the separation element, which expanse lies in the circumference direction, is smaller than the expanse of the slot, which expanse lies in the circumference direction.
  • the separation element can therefore be introduced into the slot and guided over the entire length of the tissue-protecting sleeve, to its end that faces the screw head, so that there it can act close to the screw head, in particular on the planned breaking point, and detach the tissue-protecting sleeve.
  • the separation element is configured as a blade that is guided along the planned breaking point by means of rotating the sleeve remover about its longitudinal axis and cuts this point open. By means of the blade, a clean cut is ensured, at which no splinters or chips occur and also no burrs are formed.
  • the cut edge, in particular on the screw head is not formed with a sharp edge.
  • the blade acts on the planned breaking point in the direction of the longitudinal axis of the screw, in the direction of the interior, and thereby prevents the legs from being bent open.
  • the sleeve remover For the introduction of the torque for rotating the sleeve remover, the sleeve remover has a drive opening in its circumference. A pin for the drive can be inserted into this drive opening.
  • the drive opening is arranged on the end that faces away from the legs and/or on the side that lies opposite the separation element, because handling is improved in this manner.
  • a rod can be placed into the receptacle between the legs, wherein the separation element is so far away from the edge of the sleeve remover that the separation element is assigned to the planned breaking point when the edge lies on the rod.
  • a thread for accommodating a fixation screw is formed on the inside of the legs, which thread lies below the planned breaking point.
  • the fixation screw can be put in place more easily if a sleeve thread is also present in the tissue-protecting sleeve, subsequent to the inside thread, at least over part of the longitudinal expanse of the tissue-protecting sleeve.
  • a sleeve remover having a corpus structured as a hollow cylinder and having a drive opening in its circumference, which corpus has a separation element at one end, on its inside circumference, which element is structured as a blade and extends over part of the circumference direction, wherein the sleeve remover has this configuration for interaction with the bone screw mentioned initially.
  • FIG. 1 a side view of a bone screw, the screw head of which, having two legs that form a receptacle, is connected with a tissue-protecting sleeve by way of a planned breaking point,
  • FIG. 2 a perspective representation of a sleeve remover, which has a separation element on its inside circumference surface
  • FIG. 3 a perspective representation of the bone screw, used as a pedicle screw, into the receptacle of which, in the screw head, a rod is placed between the two legs and secured by means of a fixation screw, with the tissue-protecting sleeve connected with the screw head, for the removal of which sleeve the sleeve remover is made available,
  • FIG. 4 a side section of the pedicle screw from FIG. 3 , with the tissue-protecting sleeve and the rod, in a view onto the end face of the rod, and
  • FIG. 5 the section H—H from FIG. 4 .
  • a bone screw 1 is shown in the concrete embodiment as a pedicle screw.
  • the bone screw 1 is configured with a screw shank 2 having a thread and with a screw head 3 that has two legs 5 that lie opposite one another and form a receptacle 4 between them.
  • a rod 6 can be laid into this receptacle 4 , which rod serves for correction and stabilization of a spinal column, in that adjacent vertebra or groups of vertebrae are connected with a corresponding number of pedicle screws, by means of the rod 6 .
  • the legs 5 f which form a tulip head, are connected, in one piece, in the exemplary embodiment shown, with a tissue-protecting sleeve 8 , by way of a planned breaking point 7 , which sleeve has a slot 9 that extends from its one edge all the way to the opposite edge, wherein the tissue-protecting sleeve 8 is circular in cross-section and the slot 9 extends over an arc having a length that is selected from an interval between 15° and 90°.
  • the tissue-protecting sleeve 8 has a stabilization bracket 10 on the edge that lies opposite the legs 5 and, on the side opposite the slot 9 , an opening 11 that extends from the edge facing the leg 5 , over part of the longitudinal expanse of the tissue-protecting sleeve.
  • FIG. 2 shows that a sleeve remover 12 that can be placed over the tissue-protecting sleeve 8 is provided, which remover has a separation element 14 on its inside circumference, in the configuration in which it is set onto the tissue-protecting sleeve 8 , on its end 13 facing the legs 5 , the expanse of which element, in the circumference direction, is smaller than the expanse of the slot 9 that lies in the circumference direction, so that the separation element 14 , when the sleeve remover 12 is set onto the tissue-protecting sleeve 8 , is introduced into the slot 9 and can be guided downward through the slot 9 all the way to the planned breaking point 7 .
  • the separation element 14 is configured as a blade.
  • the sleeve remover 12 therefore has a corpus 15 structured as a hollow cylinder, which corpus carries the separation element 14 at the end 13 , on its inside circumference, which element extends over part of the circumference direction.
  • the expanse is dimensioned in such a manner that the separation element 14 fits into the slot 9 , in other words can be easily introduced into it.
  • the corpus 15 has a drive opening 16 in its circumference, wherein the drive opening 16 is arranged, in the exemplary embodiment shown, at the end facing away from the legs 5 , and on the side that lies opposite the separation element 14 .
  • FIG. 3 shows that a rod 6 can be placed in the receptacle 4 between the legs 5 .
  • the sleeve remover 12 can be pushed axially onto the tissue-protecting sleeve 8 , wherein the separation element 14 is introduced into the slot 9 .
  • the separation element 14 is at such a distance from the end 13 of the sleeve remover 12 that the separation element 14 is assigned to the planned breaking point 7 when the end 13 lies on the rod 6 . If the sleeve remover 12 is now rotated by means of a pin inserted into the drive opening 16 , the blade separates the tissue-protecting sleeve 8 from the legs 5 of the screw head 2 of the pedicle screw at the planned breaking point 7 .
  • the planned breaking point is pressed in the direction of the screw axis, in other words it is ensured that the legs 5 cannot bend open and that a loss of clamping force of a fixation screw 17 is prevented, for which screw an inside thread 18 is formed on the inside of the legs 5 , which thread lies below the planned breaking point 7 and brings about securing of the rod 6 in the receptacle 4 between the legs 5 , in interaction with the fixation screw 17 .
  • the fixation screw can be placed more easily, since a sleeve thread 19 is also present in the tissue-protecting sleeve 8 , subsequent to the inside thread 18 , at least over part of the longitudinal expanse of the tissue-protecting sleeve 8 .

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
US18/286,604 2021-05-10 2021-05-10 Bone screw and sleeve remover Pending US20240197367A1 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2021/062323 WO2022237955A1 (de) 2021-05-10 2021-05-10 Knochenschraube sowie hülsenentferner

Publications (1)

Publication Number Publication Date
US20240197367A1 true US20240197367A1 (en) 2024-06-20

Family

ID=75904930

Family Applications (1)

Application Number Title Priority Date Filing Date
US18/286,604 Pending US20240197367A1 (en) 2021-05-10 2021-05-10 Bone screw and sleeve remover

Country Status (8)

Country Link
US (1) US20240197367A1 (ja)
EP (1) EP4287968A1 (ja)
JP (1) JP2024516250A (ja)
CN (1) CN117241750A (ja)
AU (1) AU2021444698A1 (ja)
BR (1) BR112023018063A2 (ja)
MX (1) MX2023012904A (ja)
WO (1) WO2022237955A1 (ja)

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2392381T3 (es) * 2008-04-22 2012-12-10 Synthes Gmbh Elemento de fijación ósea con lengüetas de reducción
DE102010060555A1 (de) 2010-11-15 2012-05-16 Ulrich Gmbh & Co. Kg Pedikelschraube
EP3092964B1 (en) * 2015-05-15 2019-04-10 BAUI Biotech Co., Ltd. Bone screw and percutaneous minimally invasive pedicle fixation system
US20190336182A1 (en) * 2015-10-27 2019-11-07 Ctl Medical Corporation Modular rod reduction tower and related methods
TWM566547U (zh) * 2018-03-21 2018-09-11 裕晟生物醫學股份有限公司 Bone nail structure

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Publication number Publication date
BR112023018063A2 (pt) 2023-11-21
WO2022237955A1 (de) 2022-11-17
JP2024516250A (ja) 2024-04-12
CN117241750A (zh) 2023-12-15
AU2021444698A1 (en) 2023-10-05
EP4287968A1 (de) 2023-12-13
MX2023012904A (es) 2023-11-09

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Owner name: ULRICH GMBH & CO. KG, GERMANY

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MIDDERHOFF, STEFAN;FROMM, MICHAEL;ZIMMERMANN, FRAUKE;SIGNING DATES FROM 20230914 TO 20230926;REEL/FRAME:065196/0163

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